Netsmart

Supergood | Netsmart API

Alex Klarfeld

Alex Klarfeld

— 6 min read
Supergood | Netsmart API

Programmatically access Electronic Visit Verification (EVV), authorizations, visit verification, and Medicaid reimbursement workflows in Netsmart (Tellus EVV) with a stable REST API. Supergood builds and operates production-grade, unofficial Netsmart integrations so your team can automate critical EVV and billing pipelines without heavy custom engineering.

Plain English: Netsmart’s EVV (provided via Tellus) is software used by home and community-based service providers, clinics, and provider groups to verify in-home services, track authorizations, manage visits, and support Medicaid billing. An unofficial API lets you create and verify EVV visits, sync patients and caregivers from your EHR, validate authorizations, assemble claim files, and reconcile payments—end to end.

If you’re a clinic, provider group, or a business focused on revenue cycle automation, connecting your tech stack to Netsmart EVV means you can tie EHR-to-EVV and billing-to-EVV data flows together. You can pull member demographics, payer authorizations, visit statuses, and claim outcomes; push roster updates, scheduled visits, check-in/out events, and claim submissions; and build features like authorization-aware scheduling, exception resolution queues, and reimbursement dashboards. This is especially impactful given growing Netsmart/Tellus EVV usage across Florida, Georgia, Kentucky, Montana, and Nebraska.

If you’re a tech company integrating with Netsmart, you can:

  • Pull: Patient/member profiles, caregiver rosters, payer authorizations, visit statuses, exception queues, verified visit exports, claim statuses, remittance summaries
  • Push: New/updated members and caregivers from your EHR, scheduled visits, check-in/out events, compliant visit edits with reason codes, claim submissions referencing verified visits
  • Build: Authorization-aware scheduling, real-time EVV exception resolution, automated claim assembly for 837P/I, reconciliation dashboards driven by EVV and remittance data

What is Netsmart?

Netsmart provides healthcare IT solutions across behavioral health, home care, hospice, and social services. Its EVV offering—delivered via Tellus—helps providers meet the 21st Century Cures Act requirements by capturing visit evidence (check-in/out, caregiver, client, GPS), managing authorizations and service codes, and connecting verified visits to Medicaid and Managed Care Organization (MCO) reimbursement workflows.

Core product areas include:

  • Electronic Visit Verification (mobile app, telephony, aggregator connections)
  • Scheduling and visit management
  • Member/client and caregiver/provider rosters
  • Payer authorizations and service codes
  • Exception handling and compliance reporting
  • Export and billing support for Medicaid/MCO claims

Common data entities:

  • Members/Clients (patients)
  • Caregivers/Providers (aides, nurses, staff)
  • Visits (EVV check-in/out, service codes, tasks)
  • Authorizations (payer, service code, units, validity dates)
  • Payers/MCOs and service programs
  • Schedules and assignments
  • Exceptions (late/missing events, GPS mismatch, overlapping visits)
  • Claims (837P/I line items referencing verified visits)
  • Remittances (835 summaries for reconciliation)

The Netsmart Integration Challenge

Organizations rely on Netsmart EVV daily, but turning portal-based workflows into automated pipelines is hard:

  • State- and payer-specific rules: Each Medicaid program/MCO may require distinct service codes, modifiers, and EVV validation logic (e.g., Florida, Georgia, Kentucky, Montana, Nebraska)
  • Strong enterprise security: SSO/MFA and network controls complicate headless automation
  • Portal-first delivery: Key EVV and exception handling lives in web apps or batch exports, not unified public APIs
  • File interfaces and timing windows: SFTP/EDI feeds, batching constraints, and daily submission windows must be respected
  • Compliance nuances: Visit edits require compliant reason codes and audit trails, and data retention rules vary by jurisdiction

How Supergood Creates Netsmart APIs

Supergood reverse-engineers authenticated browser flows, batch interfaces, and network interactions to deliver a resilient API endpoint layer.

  • Handles username/password, SSO/OAuth, and MFA (SMS, email, TOTP) securely
  • Maintains session continuity with automated refresh and change detection
  • Normalizes EVV, authorization, and claim objects so you can integrate once across states/MCOs
  • Aligns with customer entitlements and licensing constraints to ensure compliant access
  • Bridges batch exports and SFTP/EDI flows where applicable with signed URL retrieval and delivery

Use Cases

EHR-to-EVV Synchronization

  • Push patient and caregiver rosters from your EHR into Netsmart EVV
  • Create visits automatically from your scheduling system with correct service codes and modifiers
  • Maintain a single source of truth for demographics and eligibility

Authorization-Aware Scheduling and Eligibility

  • Validate authorizations before scheduling or visit creation
  • Track remaining authorized units and prevent over-utilization
  • Surface program-specific rules to care coordinators

EVV Exception Resolution

  • Pull exception queues and route issues (e.g., late arrival, missing check-out, GPS mismatch) to staff for resolution
  • Apply compliant reason codes on visit edits with audit trails
  • Escalate unresolved exceptions prior to claim submission

Claims Generation and Reimbursement Automation

  • Bundle verified visits into 837P/I claims with payer-specific formatting
  • Submit via the configured channel (state portal, MCO gateway, or clearinghouse)
  • Track claim statuses and reconcile remittances alongside EVV evidence

Audit and Compliance

  • Export complete visit packets with timestamps, locations, signatures, and reason codes
  • Maintain machine-readable audit trails aligned to state/MCO requirements
  • Prove EVV coverage and claim provenance during reviews

Available Endpoints

Authentication

POST /sessions: Establish a session using credentials. Supergood manages MFA (SMS, email, TOTP) and SSO/OAuth when enabled. Returns a short-lived auth token maintained by the platform.

curl --request POST \
  --url https://api.supergood.ai/integrations/<integration_id>/sessions \
  --header 'Authorization: Basic <Base64 encoded token>' \
  --header 'Content-Type: application/json' \
  --data '{
    "username": "[email protected]",
    "password": "<password>",
    "mfa": {
      "type": "totp",
      "code": "123456"
    }
  }'

Example response

{
  "authToken": "eyJhbGciOi...",
  "expiresIn": 3600,
  "user": {
    "id": "u_29b71a",
    "name": "EVV Admin",
    "entitlements": ["evv", "authorizations", "claims"]
  }
}

Authorizations

GET /authorizations: Retrieve payer/member service authorizations with allowed units, service codes, and date ranges. Use this to validate scheduling and claim eligibility.

Query parameters

  • memberId: string
  • providerId: string
  • serviceCode: string (HCPCS/HCPCS-like)
  • activeOn: ISO 8601 date
  • payerId: string

Example response

{
  "items": [
    {
      "authorizationId": "auth_7342c1",
      "authorizationNumber": "A-2025-11872",
      "memberId": "mem_9b42f0",
      "memberName": "Jordan Patel",
      "providerId": "prv_41cf92",
      "payerId": "payer_fl-medicaid",
      "program": "HCBS",
      "serviceCode": "T1019",
      "modifiers": ["U1"],
      "unitsAuthorized": 120,
      "unitsRemaining": 84,
      "startDate": "2026-01-01",
      "endDate": "2026-03-31",
      "status": "active"
    }
  ],
  "page": 1,
  "pageSize": 50,
  "total": 1
}

EVV Visits

POST /evv/visits: Create or update an EVV visit record with check-in/out events, service details, and verification metadata. Supports compliant edit reason codes.

curl --request POST \
  --url https://api.supergood.ai/integrations/<integration_id>/evv/visits \
  --header 'Authorization: Bearer <authToken>' \
  --header 'Content-Type: application/json' \
  --data '{
    "memberId": "mem_9b42f0",
    "caregiverId": "cgv_2208aa",
    "authorizationId": "auth_7342c1",
    "payerId": "payer_ga-medicaid",
    "serviceCode": "S5125",
    "modifiers": ["U3"],
    "checkIn": {
      "timestamp": "2026-01-19T14:02:33Z",
      "method": "mobile",
      "location": {"lat": 33.7490, "lng": -84.3880},
      "deviceId": "ios-12a3"
    },
    "checkOut": {
      "timestamp": "2026-01-19T15:01:47Z",
      "method": "mobile",
      "location": {"lat": 33.7491, "lng": -84.3882}
    },
    "tasks": ["meal_prep", "ambulation"],
    "notes": "Client requested meal prep and light housekeeping.",
    "verification": {"gpsMatch": true, "signatureCapture": true},
    "editReasonCodes": [],
    "referenceId": "ehr-schedule-42391"
  }'

Example response

{
  "visitId": "vst_58d3e0",
  "status": "verified",
  "exceptions": [],
  "createdAt": "2026-01-19T15:02:02Z",
  "referenceId": "ehr-schedule-42391"
}

Claims

POST /claims: Assemble an 837P/I claim from verified visits. Supergood normalizes service lines and can route the generated file to the configured submission channel.

curl --request POST \
  --url https://api.supergood.ai/integrations/<integration_id>/claims \
  --header 'Authorization: Bearer <authToken>' \
  --header 'Content-Type: application/json' \
  --data '{
    "claimType": "837P",
    "payerId": "payer_ky-medicaid",
    "billingProvider": {
      "npi": "1234567890",
      "taxonomy": "Home Health",
      "name": "BrightCare Home Services",
      "billingAddress": {
        "line1": "100 Care Way",
        "city": "Louisville",
        "region": "KY",
        "postalCode": "40202"
      }
    },
    "visits": [
      {"visitId": "vst_58d3e0", "units": 4, "serviceCode": "S5125", "modifiers": ["U3"]}
    ],
    "submissionChannel": "state_portal",
    "referenceId": "billing-batch-jan19"
  }'

Example response

{
  "claimId": "clm_71af2b",
  "status": "queued",
  "edi": {"format": "837P", "size": 51234},
  "submissionChannel": "state_portal",
  "createdAt": "2026-01-19T16:05:42Z",
  "reviewUrl": "https://download.netsmart.example/signed/abc123...",
  "referenceId": "billing-batch-jan19"
}

Get full API Specs →

Technical Specifications

  • Authentication: Username/password with MFA (SMS, email, TOTP) and SSO/OAuth where enabled; supports service accounts or customer-managed credentials
  • Response format: JSON with consistent resource schemas and pagination
  • Rate limits: Tuned for enterprise throughput while honoring licensing and usage controls
  • Session management: Automatic reauth and cookie/session rotation with health checks
  • Data freshness: Near real-time retrieval of visits, authorizations, and claim artifacts
  • Security: Encrypted transport, scoped tokens, and audit logging; respects Netsmart/Tellus entitlements and compliance requirements
  • Webhooks: Optional asynchronous delivery for exceptions, claim generation, and remittance updates

Performance Characteristics

  • Latency: Sub-second responses for list/detail queries under normal load
  • Throughput: Designed for high-volume EVV and batch claims pipelines
  • Reliability: Retry logic, backoff, and idempotency keys minimize duplicate actions
  • Adaptation: Continuous monitoring for UI/API changes with rapid adapter updates

Getting Started

  1. Schedule Integration Assessment

Book a 30-minute session to confirm your Netsmart/Tellus product mix, licensing, and authentication model.

  1. Supergood Builds and Validates Your API

We deliver a hardened Netsmart adapter tailored to your workflows and entitlements.

  1. Deploy with Monitoring

Go live with continuous monitoring and automatic adjustments as Netsmart evolves.

Schedule Integration Call →

Frequently Asked Questions

Q: Which Netsmart products can this integration cover?

Supergood supports workflows across commonly used Netsmart/Tellus EVV portals and agency-facing tools, subject to your licensing and entitlements. We scope coverage (e.g., mobile/telephony EVV, authorizations, visit exports, claim assembly) during integration assessment.

Q: How are MFA, SSO, and batch interfaces handled for automation?

We support username/password + MFA (SMS, email, TOTP) and can operate behind SSO/OAuth when enabled. For batch flows, we manage SFTP/EDI timing windows, generate 837 files, and retrieve signed URLs or delivery confirmations programmatically.

Q: Can I generate claims directly from verified visits?

Yes. You can assemble 837P/I from verified visits with payer-specific formatting. We can route submissions via your configured channel (state/MCO portals or clearinghouse) and return statuses and artifacts for reconciliation.

Ready to automate your Netsmart workflows?

Supergood can have your Netsmart integration live in days with no ongoing engineering maintenance.

Get Started →

Read more